Medical Insurance Biller Job at NCH Healthcare System
Business Office NCHHG
Part-Time
Day
8:00am-5:00pm
Weekend: None / Not Applicable
Req # 55841
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Essential Job Accountabilities:
- Review and edit demographic information and other Pre-Billing functions.
- Process claims through electronic system correcting all errors prior to submission.
- Validate claims sent are received by Payer (Selected Clearinghouse).
- Enters all transactional comments into the system to assure accurate account documentation.
- Meets performance goals as defined by senior management (ex: clean claim rate, etc).
- Meets productivity and quality metrics daily/weekly.
- Maintains current knowledge of Centralized Billing office billing systems.
- Maintains current knowledge of billing forms and filing requirements.
- Maintains a current knowledge of various payer contracts.
- Maintains current knowledge of Federal, State, and managed care billing methodologies, rules, and regulations.
- Ensures confidentiality of all patient accounts by following HIPAA guidelines.
- Works accounts according to the priority determined by management assignment.
- Corresponds with third party payers, physician offices and/or patients to obtain information. Escalates problems and high dollar accounts to the Revenue Cycle Denial Lead for guidance and support.
- Meets performance goals as defined by senior management (ex: A/R > 90 days, credit balance reasons, etc.).
- Meet daily and weekly productivity and quality goals.
- Informs Revenue Cycle Denial Lead of key issues on a timely basis communicating key observations, issues, and trends.
- Enters all transactional comments into the system to assure accurate account documentation.
- Maintains current knowledge of effective follow-up and collection approaches.
- Maintains current knowledge of timely payment regulations and holds payers accountable. Escalates non-compliance to senior management.
- Maintains current knowledge of hospitals’ patient accounting systems (and other related tools).
- Works closely with Cash Posting and the Credits/Refunds Team to address payment discrepancies and overpayments.
- Handles walk-in patient inquiries alongside the Customer Service Team.
- Handles billing corrections identified by the Coding Specialists.
- Works with the Customer Service Team to resolve patient inquiries received via phone calls, mail, or emails.
- Stays on top of correspondence received on patient accounts related to assignment.
- Assists Charge Posting with manual charge capture when necessary.
- Participates in general or special assignments and other duties as assigned.
- Minimum of High School Diploma or GED required.
- Minimum of 1 year work experience with one or more of the following: third party claims billing, insurance follow up, denials management, underpayments, managed care contracts, cash application, credit resolution, audit, claims processing and revenue cycle compliance in a hospital, physician’s, medical service organizations or health system revenue cycle department is required.
- Medical Terminology, Knowledge of ICD-10, HCPCS and CPT-4 codes required.
- Organizational and time management skills required.
- Proficiency in computer keyboarding skills required.
- Ability to effectively gather and exchange information in both oral and written communications.
- Ability to use MS Office Suite (Word, Excel, Outlook) at an intermediate level.
- Ability to work independently with minimal supervision.
Job Summary:This position is responsible for a variety of duties including, billing, collection, follow up, appeals process and credits to support the Revenue Cycle Lead in delivering the highest level of service. The team performs and all job-related duties as assigned. The Revenue Cycle Billing & Denial Specialist I is responsible for low dollar accounts and denials.
Essential Duties and Responsibilities:
Education, Experience, Qualifications:
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